Soft tissue Balancing In TKA Yazdi HR MD IUMS Tehran,Des, 2013

Soft tissue Balancing In TKA Yazdi HR MD IUMS Tehran,Des, 2013

Soft tissue Balancing In Varus Knee Yazdi HR MD Fellowship of Knee surgery Associated Professor of IUMS Do you do tis patient? What is your approach? How do you balance the knee?

Which implant do you prefer? Techniques : gap technique and the measured resection technique Gap technique may result in residual varus alignment in flexion( Whiteside et al)

Bone resections :according to the preoperative template on the long WB films

Tibial cutting jig :according to the talus center distally and the plateau-to-anatomic axis intersection proximally.

In constitutional metaphyseal varus deformities: usually

facing the lateral tibial plateau spine initial medial release

medial flap of tissue, which includes the meniscotibial fibers of the deep medial collateral ligament sublux the tibia forward in flexion and external rotation (RanSall maneuver) violating the posterior tibial osteophyte(pagoda) tibial and femoral

osteophytes are removed Do proximal tibial and distal femoral cuts Anteror and posterior femoral cuts

Medial pivot if needed Tight soft tissue structures in varus knees PCL Posterior capsule

Posteromedial corner with the posterior oblique Ligament (POL) Semimembranosus (direct tibial insertion) Posterior fibers of the superficial MCL

All these structures can be released with the knee in Flexion Release posterior capsule can be addressed

by a periosteal elevator

from the femoral side. figure four position to release SM and POL Release MCL Pie-crusted with a 16 Gauge needle with

multiple Punctures Distal release Shift and resect technique Medial epicondylar Ost. Effect of medial epicondylar osteotomy on soft tissue

balancing in total knee arthroplasty. Mihalko WM, Saeki K, Whiteside LA. findings of this study question the need for an epicondylar osteotomy in severe varus osteoarthritic knees. Because the knee remains unstable in flexion after this technique, an implant with higher constraint should be used. Orthopedics. 2013 Nov 1;36(11):e1353-7

Results of total knee arthroplasty with medial epicondylar osteotomy to correct varus deformity. Engh GA, Ammeen D. The results show that epicondylar osteotomy for varus knee deformity provides excellent patient satisfaction, knee stability, motion, and deformity correction.

Clin Orthop Relat Res. 1999 Oct;(367):141-8. Medial epicondyle osteotomy: a method of choice in severe varus knee arthroplasty Horia Orban Gabriel Stan Mihaela Dragusanu Razvan Adam Using medial epicondyle osteotomy for varus knee when performing total knee arthroplasty could be a useful ligament-balancing technique

to achieve medial stability of the knee. In addition, it could have considerable advantages towards the additional resection of the tibial medial plateau. European Journal of Orthopaedic Surgery & Traumatology 2012 | 22 | 7 | 579-583 Fibular Ost.

A 65 Y/o F Sever Bi varus deformity End Results Thank you

Recently Viewed Presentations

  • A Corridor to the Future - Columbia University

    A Corridor to the Future - Columbia University

    A Corridor to the Future Approaching Carbon Sequestration Investments from an Ecologically Sound Perspective Brokered by: S. Madigan Freedman Diana M. Pietri Our Field of Dreams - Pontal do Paranapamena The Odd Couple : Plot 6 and Plot 16 Plot...
  • Female Reproductive Anatomy

    Female Reproductive Anatomy

    You have a quiz on Friday of both male and female reproductive anatomy. You will be asked to identify parts and functions of both. It may have the front view or the side view. The Quizlet set has been updated...
  • National Fire Information Database

    National Fire Information Database

    A team effort between the CAFC, the CCFM&FM and our funders Canadian Safety and Security Centre, DRDC and Public Safety Canada. 3. Why . ... Calgary. Hassan. Wildland Fire-induced Risk Modelling Framework for the Greater Athabasca Oil Sand Region. 6.
  • A) The presence of nuclei can be clearly detected within each ...

    A) The presence of nuclei can be clearly detected within each ...

    B) The fur color is an adaptive form of camouflage to avoid predators. C) The dark fur absorbs more sunlight so the rabbit is warmer in winter. D) The white fur is more valuable to fur trappers, so the animal...
  • ECONOMÍA - Weebly

    ECONOMÍA - Weebly

    ECONOMÍA El término economía proviene de la palabra griega (oikos nomos), que significa "el que administra un hogar". Los hogares y las economías tienen mucho en común. Una sociedad, al igual que un hogar, ha de tomar numerosas decisiones: ¿Quién...
  • Electronic PE Offerings - United States Coast Guard

    Electronic PE Offerings - United States Coast Guard

    The SOS distress LED light must be combined with daytime flag (black square and black circle pattern) to comply with the CG day and night requirement. The SOS distress light complies with CG requirements 46 CFR 161.013. Both devices must...
  • Skepticism - Michael Johnson

    Skepticism - Michael Johnson

    If what we believed for so long was wrong, people worried, how do we know that Harvey's theory too will stand the test of time? Perhaps a new theory will come along and unseat it. This was a common Pyrrhic...
  • Vocabulary-Book the First The Tale of Despereaux:

    Vocabulary-Book the First The Tale of Despereaux:

    Ch.10-Good Reasonsrenounce. Find it in the chapter… "'But first,' said the Most Very Honored Head Mouse, 'we will give you the chance to renounce your actions." Which definition fits? verb -1. to say that you will not follow or obey...